Health Insurance At what point does private health insurance simply become uneconomical?

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OrdinaryJoe

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I think this is now a fair question to ask in the current environment. Is there a point at which, having carefully weighted up all the pros and cons, it is no longer economical for a lot of families to continue paying the cost of private health insurance in Ireland? Clearly, the answer is entirely dependent on individual circumstances and some families on higher incomes will mumble about continual price increases but continue to pay without hesitation.

My question is directed at the general population in the centre. Personally, we are 2 adults and 3 children aged 8-11. Husband and wife working with reasonable incomes, though certainly not at the higher end. Cost of living increases have certainly squeezed us and we currently just able to meet our month to month outgoings with little to spare and unable to save in any meaningful way, except to put a little aside for Christmas, special occasions etc. Outgoings and finances are reviewed regularly and we switch utilities and services whenever savings can be made. We have never made a health insurance claim and all are in good health.

Paying close to €3,000 p.a. by next renewal. There are some slightly lower priced plans but not worth it for us with the lower cover. It's a lot of money and wonder what anyone's view is about the point at which it becomes a reasonable informed choice for a family in our circumstances to discontinue private health insurance?
 
It depends on what you want private health insurance for.
Is it just to avoid Public queue for a 1st consultation, or to be able to use private hospitals or to have "high tech" hospital cover?
 
1st decision is whether you really need Mater and Blackrock. I decided I didn't, still have Beacon. This is big chunk off premium. Then consider the orthopedic if you really want 100% cover at your age. I took this out too. Then consider eliminate day to day. So these are the 3 main decisions to make IMHO.
 
I agree with OrdinaryJoe. its gone crazy out there. My insurance for my family is over 4k now. Is their any politicians looking at this, its going to become like America. Only the wealthy can afford it. Claire Byrne today talking about more increases, a couple over 80 fretting about cost increases and the recommendations was to look for cheaper cover without hip and knee cover. What kind of a country have we become if elderly pensioners are worried about such things, surely hip and knees should be standard for elderly patients. Soon we will see family cover for 10k. Their needs to be a root and branch independent review of costs and payments to consultants (lots and lots of skull dugary going on) . I personally have seen administrators pushing papers down patients neck to sign while they are so sick just to ensure payment is from the private insurance and not the public rates. I know of people who have refused to sign the documents.

The focus now is to make middle income earners pay for the broken hospital system.

God help us if their is another crash like 2008, all the signs are moving in that direction.
 
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It could be argued that there is no need for health insurance for kids in Ireland. There is free gp care, and the children’s hospitals are accessible for those who need it. Sure with VHI or Laya if you kid breaks a bone you can be in and plastered in an hour in a private clinic but you may be waiting 12 hours in A&E.

For adults it is the wait to see doctors that is the concern. I had a minor issue recently, went to my gp within days of it cropping up and got a referral to a private consultant within 4 weeks, who scheduled a small operation within another 4 weeks and job done and dusted. All very pleasant and professional, but my gp fretted it would take months to see the public clinic and would they have scheduled or even recommended the operation, would I still be fretting that the ongoing symptoms were a sign of a more serious condition, I would think so.

But I have seen excellent care in the public system, when a family member had cancer during Covid everything worked smoothly, there were zero delays with operations, chemo, radiation etc, and I saw when my 13 yr old became very ill suddenly the lengths the system went to, to find out diagnosis and start treatment. The consultants used to phone us with updates, there was zero delays in accessing them, it all worked perfectly.

But as you age the health care needs increase and do you need more access to healthcare, blood pressure, heart complaints, hips and knees, eyes, hearing, blood tests, scans, lots of medications. Will you suffer on a waiting list to get the hip done or will you go private and be seen in a timely manner. But if you do become frail you more than likely end up in the public system, the private hospitals don’t have the desire to care for people with high care needs, if you fall it is A&E, not the private hospital. My mother had multiple trips to A&E in her final months, and once spent 5 awful days in A&E, but luckily she spent her final weeks in a private hospital, where the care was 1000 times better. There was peace and quiet, not noisy public wards and she passed away with dignity. Not everyone gets that even if they have private health care.
 
In our 70's with health cover since I was 18. Probably claimed a couple of times, my wife the same.

Recent problems with hearing, eyes and dental...and guess what our policy does not cover these things. Laya Connect 600.

We have GP cards and have been in the Eye & Ear accident and emergency department about 8 times in the past two months. All for free and not a penny claimed off our health insurance.

Is there a policy out there that gives cover on eyes, dental, hearing?
 
fred123456 said:
. I personally have seen administrators pushing papers down patients neck to sign while they are so sick just to ensure payment is from the private insurance and not the public rates.
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I witnessed this last year and couldn’t believe it. Literally sticking a pen under the noses of patients who were 24 hours after major surgery, many in pain and disorientated from medication. If this isn’t exploitation of vulnerable people I don’t know what is.

fred123456 said:
I know of people who have refused to sign the documents.
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I did. They never came back to annoy me and my treatment was no different.
 
Clamball said:
It could be argued that there is no need for health insurance for kids in Ireland. There is free gp care
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In theory but if you have a kid that needs grommets, adenoids, tonsil issues to name but a few that my grandkids have had then it's a bit of a wait on the public system and if the issues are affecting sleep with the knock on effect of that it can feel like a very long wait!
 
Dr Strangelove said:
I did. They never came back to annoy me and my treatment was no different.
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Me too and believe it or not in an area just off A&E at 1 a.m. Clerical staff, but I politely told her to sling her hook which she was not pleased about. Told me that the 'office' staff would be back to me the next day. I told her no problem but in light of the fact that I was not getting a private room immediately I would hold off as instructed by my health insurer. Once she got me the room I would sign the form and I knew that the chances of me getting a private room in a public hospital were slim to none. Never heard from her or the 'office' staff again, poor disappointed girl It used to be mentioned some years back that the difference was €80 and €800 per night!!!!! so it may be more now.
 
My premium for family of 6 is 3500 per annum paid by employer but i think its BIK that I am taxed on, not sure

Either way i think its scandalously expensive. We claim the odd GP visit 50% back but the amount we claim per yr is about 300 - 500.
 
You haven't mentioned how old you are, 30's, 40's or 50's
In my day I could have done without health insurance in my 20's and 30's but not really in my 40's and definitely not my 50's
Not that I have had any major issues, main one is hight blood pressure but a day procedure in Blackrock in '21 cost Laya nearly €3k
As you get older the quicker you can get to the bottom of health issues the better so I'd be one for keeping it now as I approach 60

I've seen over the years where it's been invaluable to people of all ages and I also seen people without it suffer needlessly as they wait
My advise would be to keep it but get a policy that is going to work for you especially in the "Everyday Medical Expenses"
This year I'm on the Inspire plus plan €1546 with Laya that allows me to claim back up to 50% of €2k in medical expenses
Most of that this year will be at my opticians where I'll be able to justify a new pair as they'll be 50% off
So even though I paid €1546 for the insurance I'll get back a €1k in everyday claims that I would have had to pay in full without the insurance

So shop around an see if you can get a policy that will work for you in other ways then just the hospital cover
 
My brother was admitted through ED into ICU. He was then transferred to a private room. He has PHI but a basic plan. I advised him not to sign anything, just say he wasbt feeling well. As it happens no one came near but I think someone was on leave.

He got discharged and received a strongly worded letter asking him to sign a document and made it out he still stole money and would be jailed (OK it didn't say that but it was forceful).

I told him not to sign it. He rang and said he wouldn't sign it, he didn't ask for a private room. He got another alarming letter a week later. He replied saying again, reminding them what he said and he would not sign it as he didn't ask for a private room. He finally got a bill as a public patient.

But I could see someone signing that letter. Don't.

In defence of the clerical officers (as I work in the HSE in administrationl) they are operating on the instructions from the private sector hot shot accountants who need to maximise income for the hospital because that's what they were hired for.

These accountants get annoyed that clerical staff can't get an unconscious patient to sign a document saying they want private care. Remember if you're unconscious you're not aware that you're in a private room. If you're admitted through ED you'll get the same care. Well I hope you will. My brothers care was excellent.
 
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I attended Emegency dept in Connolly twice over 18m, I wasn't referred by Doctor and accecpted I'd be paying the 100eur.

On both occasions I was asked for my health insurance number, I declined both times as they did not need my number and knew they'd sit me on a bed somewhere for 5 mins in order to take bloods and charge Irish Life for an overnight stay.
 
Public hospitals are entitled to charge private insurers when an insured patient is admitted. If they fail to ask patients to sign the insurance form then they are throwing away money from the public purse. That would be a serious breach of their fiduciary duty to public patients and to the taxpayer. If the insurers and customers want to change the rules then they should lobby government and the Department of Health.

On the OP's question, everyone has to weigh up their own financial situation but I would be very slow to cancel or even reduce cover at any age. I have worked in public and private hospitals and I have met many people who regretted cancelling their insurance. People always think of the elderly waiting on a trolley in A&E but it's no fun in your 20s or 30s either. Life is short enough and tough enough as it is - skimping on healthcare is a false economy.
 
arbitron said:
Public hospitals are entitled to charge private insurers when an insured patient is admitted. If they fail to ask patients to sign the insurance form then they are throwing away money from the public purse.
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If Joe, who pays for insurance, has an accident and lands in A&E he is as much a public patient as John who was in the same accident and does not have health insurance. Assuming they have similar injuries they will receive similar treatment. If admitted it will probably be to the same ward (or to identical ones). Both contribute in the same way through the tax system for public health. There is no way Joe should be asked to pay twice while John pays once.
It would, of course, be different if Joe started looking for a private room, a named consultant, etc. If he does this he needs to provide his insurance details, otherwise he should not be harassed by administration.
 
Ruffian said:
There is no way Joe should be asked to pay twice while John pays once.
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I don't see anyone here disagreeing with you? The point is that the decision is not up to the public hospitals themselves; it is a matter for government and the insurers. If a hospital is legally and contractually entitled to charge insurers then it would be irresponsible in the extreme for them to ignore that revenue.
 
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